Caracterización de los pacientes reingresados por postoperatorio complicado en el servicio de Cirugía General. Hospital Universitario Comandante Faustino Pérez. Matanzas / Characterization of the patients readmitted in the service of General Surgery of the University Hospital "Faustino Perez Hernandez" of Matanzas, due to complicated post-surgery evolution

RESUMEN Introducción: la cirugía como ciencia médica tuvo grandes retos para llegar a tener una forma de tratamiento quirúrgico seguro y viable, entre estos uno de los mayores era como evitar los resultados adversos. Se realizó un análisis de los pacientes que reingresaron en el servicio de cirugía general por post operatorio complicado. Objetivo: determinar las causas de reingresos por postoperatorio complicado en el servicio de cirugía general. Material y métodos: se realizó un estudio prospectivo - descriptivo- observacional sobre el universo, que fueron todos los pacientes reingresados por postoperatorio complicados, por el servicio de Cirugía General. Se analizaron múltiples variables que pudieran estar en relación con los reingresos las cuales fueron obtenidas a través de una planilla de recolección de datos y procesadas por el programa computadorizado Microsoft Office 2009. Resultados: los pacientes que reingresaron, el mayor porcentaje son del sexo masculino, de la raza blanca y los mayores de 60 años. Los reingresos por complicaciones postquirúrgicas representan un bajo por ciento respecto al volumen de casos que son intervenidos y la principal causa de reingreso fue la infección del sitio quirúrgico, las variables analizadas las que más se relacionaron con los reingresos fueron las operaciones realizadas por vía convencional, atendidos en salas abiertas, con operaciones limpias contaminadas. Conclusiones: de los pacientes que reingresaron 6 de cada 10 son del sexo masculino de la raza blanca y su edad mayor de 60 años (AU).

SUMMARY Introduction: Surgery, as a medical science, faced big challenges to become a form of a safe, feasible surgical treatment; among them, one of the biggest was avoiding adverse outcomes. The authors carried out an analysis of the patients readmitted in the service of General Surgery of the University Hospital "Faustino Perez Hernandez" of Matanzas due to complicated post-surgery evolution in the period from January 2016 to December 2018. Objective: to determine the causes of readmissions due to complicated post-surgery evolution in the service of General Surgery of the University "Hospital Faustino Perez Hernandez". Materials and methods: a prospective, descriptive, observational study was carried out on a universe of all patients readmitted in the service of General Surgery due to complicated post-surgery evolution. The authors analyzed several variables that could be related to readmissions and were obtained from a data collection form and processed with the computer program Microsoft Office 2009. Results: the main results were that among readmitted patients, the highest percent were male, white and elder than 60 years old. Readmissions due to post-surgery complications represent a low percent with respect to the quantity of patients who underwent surgery, and the main cause of readmission was infection at the surgery site. From the analyzed variables the once related the most with readmissions were conventional surgeries, patients looked after in open wards, with contaminated clean operations. Conclusions: six from each ten patients were male, white, and aged more than 60 years (AU).

Risk factors and postoperative complications in oncologic surgeries / Fatores de risco e complicações pós operatórias em cirurgia oncológica

Abstract Introduction: Oncological patients who are submitted to surgical procedures might have postoperative pulmonary complications (PPCs). Thus, preoperative physical conditions must be considered, since it is an important predictor of postoperative development. Objective: The purpose of this study was to analyze the risk factors for postoperative pulmonary complications that might compromise the recovery after oncologic surgery. Method: The present observational transversal study was made between March and October of 2015. Patients diagnosed with cancer were analyzed to determine pulmonary and functional condition and to identify the risk factors for the development of PPCs. The post-surgery recovery was followed through medical records. Data collected from patients' analyses was correlated with post-surgery development. Results: Thirty patients were analyzed. A negative and moderate correlation was found between maximal inspiratory pressure (MIP) and PPCs (r=-0.39; p=0.032). A positive correlation between the time of permanence in the Intensive Care Unit (ICU) and hospitalization days (r=0.40; p=0.02) was observed. Correlations between PPCs and mechanical ventilation (r=0.36; p=0.04) and hospitalization days (r=0.40; p=0.02) were also noticed in the present study. Conclusion: PPCs might prejudice post-surgery outcome. The greater are physical condition and pulmonary functions of the patients before surgery, the better is their recovery.

Resumo Introdução: Pacientes oncológicos submetidos a procedimentos cirúrgicos podem apresentar complicações pulmonares no pós-operatório. A condição física pré-operatória deve ser considerada, pois é um importante preditor do desenvolvimento pós-operatório. Objetivo: Analisar os fatores de risco para complicações pulmonares pós-operatórias (CPPO) que podem comprometer a recuperação após a cirurgia oncológica. Método: O presente estudo observacional transversal foi realizado entre os meses de março e outubro de 2015. Pacientes oncológicos participaram de uma avaliação para determinação da condição pulmonar e funcional pré-operatória e identificação dos fatores de risco para desenvolvimento de CPPO. A evolução pós-operatória foi acompanhada por meio de prontuários. Os dados coletados da avaliação foram correlacionados com o desenvolvimento pós-operatório. Resultados: Trinta pacientes foram analisados. Foi encontrada correlação negativa e moderada entre a PImáx e as CPPO (r=-0,39; p=0,032). A permanência na UTI apresentou correlação positiva com os dias de internamento hospitalar (r=0,40; p=0,02). A ventilação mecânica (r= 0,36; p=0,04) e os dias de internamento no hospital (r=0,40; p=0,02) tiveram correlação com o tipo de CPPO. Conclusão: CPPO podem prejudicar o desfecho pós-operatório. Bom estado físico e boa função pulmonar prévias à cirurgia oncológica possibilitam melhor desempenho para o paciente no pós-operatório.

Cuidado de enfermería postoperación de Tromboendarterectomia Pulmonar Bilateral. Estudio de caso fundamentado en los principios de Henderson / Nursing care after Bilateral Pulmonary Thromboendarterectomy. Case study based on Henderson's principles / Cuidados de enfermagem após tromboendarterectomia pulmonar bilateral. Estudo de caso baseado nos princípios de Henderson

Resumen Introducción La tromboembolia pulmonar (TEP) es un padecimiento que se presenta con frecuencia de manera silenciosa, el 50 % o más de los casos no se diagnostica. Se define como la oclusión total o parcial de la circulación pulmonar, ocasionada por un coágulo sanguíneo proveniente de la circulación venosa sistémica, incluidas las cavidades derechas y que, de acuerdo a su magnitud, puede o no originar síntomas. Está considerada como una urgencia cardiovascular y constituye una de las principales causas de morbimortalidad en pacientes hospitalizados. Objetivo Desarrollar un Estudio de caso basado en el Proceso de Atención de Enfermería en la persona postoperada de Tromboendarterectomía Pulmonar Bilateral en Unidad de cuidados intensivos postquirúrgica de un Instituto Nacional de Tercer Nivel de la Ciudad de México. Método Estudio de caso basado en las etapas del proceso enfermero, se utilizó una Guía de valoración de las 14 necesidades de Virginia Henderson, jerarquización de Diagnósticos enfermeros, se ofreció una atención integral enfocada en cuidados especializados para cubrir las necesidades más afectadas en la persona. Conclusiones La aplicación del proceso de atención enfermero con base en la valoración de las 14 necesidades de Virginia Henderson, identificó que las necesidades más afectadas fueron; Oxigenación/Circulación y Evitar peligros, con la jerarquización se determinó que es imprescindible el conocimiento de enfermería en intervenciones especificas en el proceso postoperatorio de Tromboendarterectomía como: la detección del riesgo de alteraciones del ritmo cardiaco, valoración e intervenciones en insuficiencia respiratoria aguda, la propensión a eventos trombóticos secundarios a afección genética, para el logro de la recuperación de la salud de manera exitosa.

Abstract Introduction Since a pulmonary embolism (PE) can develop silently, more than 50 % of cases are not diagnosed until clear signs and symptoms are present. It is defined as the partial or total blockage of pulmonary circulation due to a blood clot which originated from the venous circulation elsewhere. Considered a cardiovascular urgency, it is a main cause of morbidity and mortality among hospitalized patients. Objective Based on the Nursing Process, to carry out a study case on a person who underwent surgery for Bilateral Pulmonary Thromboendarterectomy in the ICU of a Third Level of Care National Institute of Mexico City. Method This is a study case which followed the stages of the Nursing Process. An assessment guide of the 14 needs proposed by Virginia Henderson was utilized. Nursing diagnoses were ranked. An integral and specialized care addressing the patient's most important needs was offered. Conclusions The most important needs identified were: promoting oxygenation and circulation, and preventing risks. From the diagnoses analysis, it was determined that nursing knowledge is crucial in post thromboendarterectomy interventions, in terms of heart rate alteration risk detection, acute respiratory insufficiency assessment, and secondary thrombotic events prevention, all these in order to achieve a successful recovery.

Resumo Introdução A trombo embolia pulmonar (TEP) é uma doença que se apresenta com frequência de maneira silenciosa, o 50 % ou mais dos casos não se diagnostica. Define-se como a oclusão total ou parcial da circulação pulmonar, ocasionada por um coágulo sanguíneo proveniente da circulação venosa sistémica, incluídas as cavidades direitas e que, conforme sua magnitude, pode ou não originar sintomas. É considerada como uma urgência cardiovascular e constitui uma das principais causas de morbimortalidade em pacientes hospitalizados. Objetivo Desenvolver um Estudo de caso baseado no Processo de Atenção de Enfermagem na pessoa pós-perada de Tromboendarterectomia Pulmonar Bilateral na Unidade de cuidados intensivos post-cirúrgica de um Instituto Nacional de Terceiro Nível da Cidade do México. Método Estudo de Caso baseado nas etapas do processo enfermeiro, utilizou-se uma Guia de avaliação das 14 necessidades de Virginia Henderson, hierarquização de Diagnósticos enfermeiros, ofereceu-se uma atenção integral focalizada em cuidados especializados para cobrir as necessidades mais afetadas na pessoa. Conclusões A aplicação do processo de atenção enfermeiro com base na avaliação das 14 necessidades de Virginia Henderson, identificou que as necessidades mais afetadas foram; Oxigenação/Circulação e Evitar perigos, com a hierarquização determinou-se que é imprescindível o conhecimento de enfermagem em intervenções especificas no processo pós-operatório de Tromboendarterectomia como: a detecção do risco de alterações do ritmo cardíaco, avaliação e intervenções em insuficiência respiratória aguda, a propensão a eventos trombóticos secundários a afecção genética, para o sucesso da recuperação da saúde de maneira bem-sucedida.

Lesión renal aguda en pacientes sometidos a apendicectomía / Acute renal lesion in patients submitted to apendicectomy

Resumen ANTECEDENTES: la lesión renal aguda es una disfunción aguda multifactorial. En el periodo posquirúrgico aumenta la mortalidad y morbilidad y existe poca información acerca de lesión renal aguda en cirugías no cardiacas. El gasto urinario es un índice funcional y biomarcador de lesión tubular, aparte de los criterios diagnósticos. OBJETIVO: determinar la incidencia de lesión renal aguda en pacientes posapendicectomía, la existencia de oliguria posquirúrgica y los factores de riesgo de lesión renal aguda. MATERIAL Y MÉTODO: estudio observacional, transversal, retrospectivo, en el que revisamos los expedientes de pacientes sometidos a apendicectomía de febrero de 2015 a enero de 2016 en el Hospital Ángeles Pedregal. Incluimos pacientes mayores de 18 años y excluimos a los pacientes sin control de líquidos. Se definió y clasificó la lesión renal aguda con las guías KDIGO. Los datos demográficos se expresan en medianas. Utilizamos χ2 de Pearson como medida no paramétrica y presentamos datos en razón de momios (OR) con intervalo de confianza (IC) de 95%. RESULTADOS: en 12 meses se revisaron 196 expedientes; 114 pacientes no cumplieron con control de líquidos y se excluyeron, quedaron 82 pacientes para análisis. Encontramos incidencia de 26% de lesión renal aguda, 48% en estadio 1 y 52% en estadio 2. El 62% eran mujeres. La mediana de edad en el grupo de lesión renal aguda fue de 38 años (límites: 18-77). Del grupo sin lesión renal aguda, 54% tuvo oliguria transitoria en recuperación y 21% oliguria transitoria a las cuatro horas. En el grupo de lesión renal aguda, 76% tenía oliguria en recuperación (p=0.097, OR 2.54 IC 95% 0.826-7.820). El 81% tenía oliguria cuatro horas después de la cirugía (p≤0.05, OR 13.66 IC 95% 3.94-47.6), la sensibilidad y especificidad fueron de 80 y 79%, respectivamente; el valor predictivo positivo fue de 56% y el valor predictivo negativo de 92%. CONCLUSIONES: encontramos incidencia similar a la reportada en estudios previos; sin embargo, tuvimos más casos de estadio 2. Encontramos una asociación estadísticamente significativa entre diuresis media horaria a las cuatro horas y lesión renal aguda. La lesión renal aguda en el periodo posquirúrgico se ha relacionado con mal pronós tico, por lo que su detección oportuna para el manejo adecuado es importante. La existencia de lesión renal aguda en nuestra población es considerable y el control estricto de líquidos es indispensable para la detección oportuna, la medición de la diuresis media horaria cuatro horas después de la cirugía puede alertar sobre qué pacientes pueden padecer lesión renal aguda a las 6 y 12 horas, para iniciar la intervención y abordaje oportunos.

Abstract BACKGROUND: Acute kidney injury (AKI) is a multifactorial acute dysfunction. In the postoperative period is associated with more morbidity and mortality and we have little information on AKI in noncardiac surgeries. Urine output (UO) is a functional index and a biomarker of tubular injury. OBJECTIVE: To determine the incidence of AKI in patients post-appendectomy, the presence of postoperative oliguria and risk factors. MATERIAL AND METHOD: An observational, transversal, retrospective study was done. We reviewed records of patients undergoing appendectomy from February 2015 to January 2016 in the Hospital Ángeles Pedregal, Mexico City. We included patients aged 18 years and excluded patients without control of liquids. AKI was defined and classified by KDIGO guidelines. Demographics were expressed in medians. We used χ2 Pearson as parametric measure and present data in OR with confidence interval (CI) 95%. RESULTS: In 12 months, 196 cases were reviewed. 114 patients did not meet fluid control and were excluded, left 82 patients for analysis. We found an AKI incidence of 26%, AKI I, 48% and AKI II, 52%. The median age in the AKI group was 38 years (18-77). From no-AKI group, 54% showed transient oliguria recovering transient oliguria and 21% at 4 hours. In the AKI group, 76% had oliguria in recovery (p=0.097, OR 2.54 95% CI 0.826-7.820); 81% had oliguria at 4 hours after surgery (p≤0.05, OR 95% CI 3.94-47.6 13.66), sensitivity and specificity of 80% and 79%, PPV 56% and NPV 92%. CONCLUSION: We found a similar incidence reported in previous studies; however, we have more AKI II cases. We found a statistically significant association between UO 4 hours and AKI. AKI in the postoperative period has been associated with poor prognosis, so that timely detection for the proper handling is important. The presence of AKI in our population is considerable and strict control of fluids is essential for early detection, UO 4 hours after surgery can alert that patients may have AKI at 6 and 12 hours, starting an intervention.

Therapeutic Observation of Acupoint Thread Embedding in Preventing Urinary Retention After Cervical Cancer Surgery / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint thread embedding in preventing urinary retention after cervical cancer surgery.Method Fifty eligible patients were randomized into a treatment group and a control group, 25 cases each. The control group was given catheterization after gynecological surgery; the treatment group was intervened by thread embedding at Zusanli (ST36), Sanyinjiao (SP6), Yinlingquan (SP9), Guanyuan (CV4), and Shenshu (BL23) on the 7th day after the surgery in addition to the basic intervention given to the control group. The indwelling catheter was removed on the 14th day after the surgery, and the bladder function, urination, and residual urine volume were compared between the two groups.Result After the treatment, the bladder function in the treatment group was significantly better than that in the control group (P<0.05); the markedly effective rate of spontaneous micturition was 92.0% in the treatment group versus 72.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Early intervention with acupoint thread embedding after cervical cancer surgery can effectively decrease the incidence of post-surgery urinary retention, and it's easy-to-operation and worth application in clinic.

Therapeutic Observation of Acupoint Thread Embedding in Preventing Urinary Retention After Cervical Cancer Surgery / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint thread embedding in preventing urinary retention after cervical cancer surgery.Method Fifty eligible patients were randomized into a treatment group and a control group, 25 cases each. The control group was given catheterization after gynecological surgery; the treatment group was intervened by thread embedding at Zusanli (ST36), Sanyinjiao (SP6), Yinlingquan (SP9), Guanyuan (CV4), and Shenshu (BL23) on the 7th day after the surgery in addition to the basic intervention given to the control group. The indwelling catheter was removed on the 14th day after the surgery, and the bladder function, urination, and residual urine volume were compared between the two groups.Result After the treatment, the bladder function in the treatment group was significantly better than that in the control group (P<0.05); the markedly effective rate of spontaneous micturition was 92.0% in the treatment group versus 72.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Early intervention with acupoint thread embedding after cervical cancer surgery can effectively decrease the incidence of post-surgery urinary retention, and it's easy-to-operation and worth application in clinic.

Comparison of incidence of ptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification.

Objective: To compare the incidence of upper eyelid blepharoptosis after combined phacotrabeculectomy with mitomycin C and phacoemulsification surgeries and the relationship of bleb morphology to the incidence of ptosis. Design: Retrospective observation study. Participants: We included 46 patients after combined phacotrabeculectomy and 44 patients with phacoemulsification in the former group, and all eyes underwent a standardized two‑site surgery with intra‑operative mitomycin C. Materials and Methods: Postoperative ptosis was defined as a reduction of upper marginal reflex distance 2 mm in the operated eye compared to the fellow eye. Trabeculectomy bleb measurements were carried out using anterior segment optical coherence tomography (VisanteTM, Carl Zeiss Meditec, Dublin, CA, USA) which included bleb height and total area of the bleb. Results: There were 8 eyes (17.4%) and 5 eyes (11.4%) with postoperative ptosis in the phacotrabeculectomy and phacoemulsification groups, respectively (P = 0.342). In multivariate regression analysis, reduced total bleb area was significantly associated with upper eyelid ptosis after adjusting for age, gender, and type of anesthesia. The trend seemed to show that increased bleb height was also associated with ptosis, but this did not reach statistical significance. Conclusions: Incidence of persistent ptosis after phacoemulsification combined with trabeculectomy and mitomycin C is similar compared to stand alone phacoemulsification surgery in a multiethnic Asian population. Bleb morphology may play an important role in postoperative ptosis development and should be considered in the evaluation of upper eyelid blepharoptosis.

A enfermagem e a dor do paciente na sala de recuperação pós-anestésica: formas de identificação e condutas interventivas / Nursing and patient`s pain in post-anesthetic recovery room: forms of identification and interventional conduct

O presente estudo refere-se a uma pesquisa qualitativa envolvendo o profissional de enfermagem que exerce sua função na Sala de Recuperação Pós-Anestésica (SRPA) relativamente à atenção ao paciente no período pós-anestésico. Objetivo: pretende-se averiguar a percepção desse profissional mediante a dor do paciente no pós-operatório e as formas de conduta implementadas por ele no atendimento à queixa do paciente. Método: os dados foram coletados através de entrevistas semi-estruturadas, gravadas e posteriormente transcritas na integra para avaliação. A delimitação da amostra seguiu os critérios da Técnica de Saturação. Os resultados foram analisados através da Técnica de Análise de Conteúdo de Lawrence Bardin. Resultados e Discussão: os resultados do estudo demonstraram a existência de uma distância entre o ideal de uma prática de enfermagem na SRPA e as ações ali efetivadas no cotidiano de enfermeiros e pacientes. Conclusão: assim considera-se que os resultados do estudo em questão contribuirão para objetivação de condutas mais efetivas por parte dos profissionais em relação aos pacientes pós-operados, o que poderá trazer ganhos importantes na recuperação de sua saúde...

The present study refers to a qualitative research involving the nursing professional which plays a role in the Post-Anesthetic Care Unit (PACU) related to caring of these cases. Objective: it is intended to ascertain his perception through the pain of the patient after the surgery and the forms of conduct implemented by this professional in attending to patient`s complaints. Method: the data were collected through semi-structured recorded interviews which were later transcribed for evaluation through Bradin`s content analyzes technique. The delimitation of the sample followed the Saturation Technique criteria. Results and Discussion: They confirmed the existence of a gap between the ideal nursing practice in a PACU and the actions effectively taken in the routine of nurses and patients. Conclusion: thus, the results of the study will ertainly contribute to a more effective conduct of professionals regarding post-surgery patients, which will bring significant gains in the recovery of heir health...

Terceros molares retenidos, su comportamiento en Cuba. Revisión de la literatura / Retained third molars, their behavior in Cuba. Literature review

Introducción: el objetivo de este trabajo es realizar una revisión bibliográfica sobre la información de estudios realizados y publicados en diferentes provincias de Cuba, en los que se abordan las complicaciones pre y posoperatorias de los terceros molares retenidos. Metodología: se desarrolló una estrategia de búsqueda con los términos: tercer molar retenido, meta-análisis, revisión sistemática, combinados con complicaciones pre y posoperatorias, utilizando las publicaciones encontradas desde enero de 1990 hasta junio de 2013. Discusión: se encontró en todos los estudios realizados en las diferentes provincias de Cuba, que los terceros molares son los dientes que presentan mayor posibilidades de retención, por lo que casi siempre tienen indicación de tratamiento quirúrgico, presentando diferentes complicaciones tanto pre como posoperatoria. Conclusiones: con esta revisión llegamos a la conclusión de que en los estudios realizados en las diferentes provincias de Cuba, la complicación preoperatoria más frecuente causada por terceros molares retenidos fue la pericoronaritis, la cual siempre viene acompañada de dolor y edema, y las complicaciones más frecuentes después de la cirugía son la celulitis facial posoperatoria, acompañada casi siempre de trismo y dolor.

Background: the aim of this work is developing a bibliographic review on the studies carried out and published in several Cuban provinces, approaching pre-surgery and post-surgery complications of the third retained molars. Methodology: we developed a search strategy with the terms: third retained molar, meta-analyses, systematic review, combined with pre- and post-surgery complications, using literature published from January 1990 to June 2013. Discussion: in all the studies made in different Cuban provinces we found that the third molars are the teeth having greater retention possibilities, therefore their surgical treatment is almost always indicated; they present different pre- and post-surgery complications. Conclusions: with this review we arrived to the conclusion that in studies carried out in different Cuban provinces, the most frequent pre-surgery complication caused by the retained third molars was pericoronaritis, always accompanied by pain and edema, and the most frequent post-surgery complication was facial cellulites, almost always accompanied with trismus and pain.

Effect evaluation of NBASS-APS in patients with abdominal surgery / 中国实用护理杂志

Objective To evaluate the application effect of nurse based,with clinicians and anesthesiologists supervised acute pain service (NBASS-APS)in clinical postoperative pain management.Methods 300 cases of abdominal surgery were divided into the observation group and the control group with 150 cases in each group,the observation group was given NBASS-APS,the control group used the traditional acute pain service mode.The total cost and postoperative analgesia effect were recorded in all patients.Results The hospitalization costs,anal exhaust time,ambulation time and hospital stay in the observation group were significantly less than those in the control group,and postoperative 48h sleep time was significantly longer than that in the control group,VAS scores of each time period were significant-ly lower than those in the control group,there was significant difference.Conclusions Application of NBASS-APS in patients after abdominal surgery can effectively reduce hospitalization costs and improve cost efficiency.

Fraturas transtrocanterianas: uso de alendronato no pós-operatório / Transtrochanterian fractures: postoperative use of alendronate

OBJETIVO: Avaliar resultados do uso de alendronato de sódio em pós operatório de fratura transtrocanteriana. MÉTODO: Durante seis meses, 75 pacientes foram atendidos no Serviço de Ortopedia devido à fratura transtrocanteriana de fêmur, sendo submetidos a tratamento cirúrgico com fixação através de placa DHS 135º. Foram selecionados 19 pacientes, hígidos, cooperativos, previamente deambuladores, classificados segundo Tronzo em tipo III e cujos quadris contra laterais não haviam sido submetidos a nenhuma cirurgia prévia, permitindo a realização de Densitometria Óssea Mineral no pós-operatório imediato e após seis meses. Os pacientes foram divididos em grupos I e II, com e sem uso de alendronato de sódio, a partir do pós-operatório imediato, respectivamente. O seguimento mínimo foi de seis meses. Após quatro semanas, os pacientes foram avaliados de acordo com a Escala Visual Analógica de Dor (EVA), para observação do índice de reabsorção óssea, a massa óssea e a consolidação radiológica da fratura. RESULTADOS: Houve uma tendência estatística de consolidação radiológica mais precoce com menor reabsorção óssea nos pacientes com uso de alendronato de sódio na pós-fratura com osteoporose estabelecida. CONCLUSÃO: Concluímos que, radiologicamente, os pacientes que utilizaram alendronato de sódio tiveram uma consolidação óssea mais rápida, com menor índice de reabsorção.

OBJECTIVE: To evaluate the results of the use of alendronate sodium in postoperative transtrochanteric femoral fractures. METHOD: Over a six-month period, 75 patients were treated at the Orthopedic Service for transtrochanteric femoral fractures, undergoing surgery with 135 degree DHS plate fixation. We selected 19 patients who were healthy, cooperative, previously unable to walk, classified as type III according to Tronzo, whose contralateral hips had not undergone any previous surgery, enabling the evaluation of bone mineral density (BMD) in the immediate postoperative period and after six months. The patients were divided into groups I and II, with and without the use of alendronate sodium in the immediate postoperative period, respectively. The minimum follow-up was six months. After four weeks, the patients were evaluated according to the Visual Analogue Scale for Pain (VAS) in order to verify the rate of bone resorption, bone mass and radiological consolidation of the fracture. RESULTS: There was a statistical trend of earlier radiological consolidation and lower bone resorption in patients with the use of alendronate sodium in post-fracture with established osteoporosis. CONCLUSION: We concluded that radiologically, patients using alendronate sodium showed faster bone consolidation, with a lower rate of resorption.

Quality Of Life amongst Post Coronary Artery Bypass Patients at the National Heart Institute, Malaysia

Coronary Artery Bypass Grafting (CABG) surgery has increased the survival rate for individuals suffering from myocardial infarction or coronary ischemia. The present study aimed to examine the perception of quality of life amongst post CABG patients at the National Heart Institute Malaysia. A total of 69 post CABG patients, were studied using the Medical Outcomes Short Form 36 (SF-36). The findings showed that post CABG respondents possessed good level of quality of life (SF-36) physically and mentally. There were significant differences between the role physical in the physical functioning domains of quality of life with gender (t=0.286, p<0.05). Duration of physical exercises of more than 20 minutes have positive effects on both physical (t=2.738, p<0.05) and mental components (t=7.326, p<0.05). The level of income influenced both the physical component (F=3.100, p<0.05), and mental component (F=4.272, p<0.05). Post CABG patients were found to have high quality of life post operatively. They were able to make comprehensive lifestyle changes through frequent physical exercises to accommodate their needs.

Modelo de atención en el paciente postoperado de columna vertebral en el Instituto Nacional de Rehabilitación / Attention model in the patient with column surgery in the National Institute of Rehabilitation

Los avances científicos y tecnológicos en la cirugía de columna vertebral han permitido disminuir tiempos quirúrgicos y abatir costos tanto para el paciente como a la institución. A fin de contribuir a lo antes señalado; en el Instituto Nacional de Rehabilitación (INR) se ha establecido un modelo de cuidado que permite reducir en los pacientes postquirúrgicos complicaciones; estancia hospitalaria prolongada y una rehabilitación tardía. Actualmente el paciente puede movilizarse en las primeras veinticuatro horas del postoperatorio evitando así daños relacionados con el reposo prolongado como neumonía hipostática; úlceras por presión; intestino perezoso por mencionar algunos. Enfermería es parte fundamental en el tratamiento y rehabilitación de los pacientes; por lo que hoy en día requiere de una preparación profesional especializada para brindar proporcionar un mejor cuidado de enfermería entre los que se destacan los dirigidos a la prevención de estas repercusiones y colaborar a que el paciente participe en la rehabilitación efectiva en menor tiempo.

Scientific and Technologic advances have reduced vertebral column surgical times, saving cost both to the patient and the institution. In accordance, The National Institute of Rehabilitation ( INR) has established a care model which, furthermore, allows reduce patient post-surgical complications, hospital permanence, and rehabilitation times. Currently, the patient can be mobilized within the first 24 hours after surgery, therefore avoiding extended rest-related, damages such as hypostatic pneumonia, pressure sores, and slow bowel movements Nursing fundamental role in this process implies its continuous specialization improvement.

Clinical Study of Pingyi Mixture on Resisting Tumour Transfer after Surgery / 中国中医药信息杂志

Objective To observe the effect of Pingyi(PY) Mixture combined with chemotherapy to Ⅱ～Ⅲ patients after tumour surgery which can resist transference and recurrence of tumour.Method According to the random principle,120 patients who had suffered the surgery of commonly seen tumour were divided into observed group and matched group.Observed group adopted PY Mixture combined with chemotherapy and matched group adopted simple chemotherapy.After 3 periodic treatments,the effect of the patients after tumour surgery was observed including the ratio of recurrence and transference of observed group within 1 or 2 years,survival ratio,quality of life,body weight,immunological indexes,the toxic and sub-effect,the blood rheology behavior,and compared with simple chemotherapy.Results The ratio of recurrence and transference of observed group within 1 or 2 years was respectively 25.74% and 31.43%,which was obviously lower than that of control group,which was 32.00%,52.00%(P